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晚期卵巢上皮性癌的预后变化及影响因素分析

Prognosis and Prognostic Factor Analysis of Advanced Epithelial Ovarian Cancer

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【作者】 温宏武孙伟杰郭燕燕刘书文

【Author】 Wen Hongwu, Sun Weijie, Guo Yanyan, et al. First School of Clinical Medicine, Beijing Medical University, Beijing 100034

【机构】 北京医科大学第一医院妇产科

【摘要】 目的:了解近20余年晚期卵巢上皮性癌的预后有无改善,及影响预后的因素。方法:对1970年至1993年在我院住院治疗的140例晚期卵巢上皮性癌病例进行分析,按患者的初治时间分为两组,1980年1月以前的56例为第1组,之后的84例为第2组,计算两组的Kaplan-Meier生存率曲线,用SPSS及SURVCALC统计软件对资料进行单因素及COX逐步回归分析,确定影响患者预后的因素。结果:两组的病理资料无差异,但第2组得到了更积极的化疗。总的1年、2年及5年生存率分别为61.2%、32.1%和8.5%,第1组分别为42.3%、29.6%和4.5%,第2组分别为69.3%、36.2%和11.2%,第2组预后好于第1组(P<0.05)。临床分期晚、分化差、残余瘤直径>2cm者预后差。联合化疗≥4个疗程者预后改善,≥6个疗程者又较≥4个疗程者预后好。结论:晚期卵巢上皮性癌的预后近10余年来有所改善,提高肿瘤细胞减灭术的彻底性及行至少6个疗程的联合化疗是改善预后的重要措施。

【Abstract】 Objective:To investigate the prognosis change and prognostic factors of advanced epithelial ovarian cancer in recent over twenty years. Methods:One hundred and fourty patients with advanced epithlial ovarian cancer were analyzed. They were divided into two groups based on their operation time. 56 patients operated before Jan. 1980 were included in the first group, and the other 84 patients in the second group. Kaplan Meier survival curves of the two groups were calculated, and COX model was used to evaluate the prognostic factors of the disease at univariate and multivarivate levels using SPSS and SURVCALC software. Results:There was no pathological difference in between the two groups, but the patients in the second group received more aggressive chemotherapy. The overall 1 , 2 and 5 year survival rates were 61.2%, 32.1%, and 8.5%, respectively. In the first group they were 42.3%, 29.6% and 4.5% respectively and in the second group 69.3%, 36.2%, and 11.2% respectively. The prognosis of the patients in the second group was better than that in the first group, P <0. 05. Univariate analysis revealed that stage, grade, residual tumor size and chemotherapy were significant predictors of patients’outcome. COX regression analysis identified that they were all independent prognostic factors. The patients with advanced, low grade, residual tumor (>2 cm) had poor prognosis. The prognosis of the patients who received equal or more than four, especially six cycles combined chemotherapy was improved. Conclusion: The prognosis of the patients with advanced ovarian cancer has improved in recent over 10 years, higher optimal cytoreductive rate and equal or more than six cycles combined chemotherapy are important measures for the better prognosis of advanced ovarian cancer.

【关键词】 卵巢肿瘤预后
【Key words】 Ovarian neoplasms Prognosis
  • 【文献出处】 中华妇产科杂志 ,Chinese Journal of Obstetrics And Gynecology , 编辑部邮箱 ,1997年03期
  • 【分类号】R737.31
  • 【被引频次】20
  • 【下载频次】65
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